The device according to the present invention is particularly suitable, although not exclusively so, for use in celioscopy, and it is described hereinafter principally in relation to this application.
It is known that celioscopy does not allow an operating site to be cleaned in the way it is in open surgery, for example by using sterile compresses. It has thus been necessary to design devices with which it is possible, on the one hand, to convey physiological serum, optionally heated, to an operating site, and, on the other hand, to remove from this operating site the blood, the secretions and the used physiological serum.
Such a device which is known includes:
an oblong body intended to serve as a grip for the surgeon; PA1 a first tubular connector arranged at one end of said oblong body and intended to be brought into communication with the operating site, generally by way of an elongate cannula; PA1 second and third tubular connectors arranged at the other end of said oblong body and intended to be connected, respectively, generally by way of flexible conduits, to a source of irrigating liquid and to aspiration means, said irrigating liquid coming from a reservoir under pressure or else being conveyed to the operating site solely by force of gravity; PA1 two connecting lines inside said oblong body and connecting said first tubular connector to said second and third tubular connectors, respectively, it being possible for said connecting lines to be flexible tubes which can be crushed; and PA1 selective control means mounted in said oblong body and capable of controlling the fluid circulation in said connecting lines, said selective control means being actuated by manual actuating members appearing at the surface of said oblong body so as to be available to the surgeon. For each connecting line, said selective control means can comprise a guillotine system capable of crushing the corresponding flexible tube, and said actuating members can include a push button. Generally, when the surgeon is not acting on the push button, each guillotine system crushes the corresponding flexible tube by virtue of the action of at least one spring, and this interrupts the fluid communication in the corresponding connecting line, whereas, in order to establish this communication, the surgeon has to press on said push button in order to counteract the action of said spring. PA1 said oblong body: PA1 said surgical device includes:
When operating, the surgeon holds said oblong body in the cradle formed by the little finger, the ring finger, the middle finger and the index finger of one of his hands and operates said push buttons with the thumb of said hand.
When the surgeon presses with his thumb on the push button associated with the connecting line joining the first tubular connector to said second tubular connector, without touching the other push button, he establishes the connection between said source of irrigating liquid and the operating site, whereas the communication is cut between the latter and the aspiration means. By contrast, when the surgeon presses with his thumb on the push button associated with the connecting line joining the first tubular connector to said third tubular connector, without touching the other push button, he establishes the connection between the operating site and said aspiration means, whereas the communication is cut between said source of irrigating liquid and said operating site.
Although they give complete satisfaction from the operational point of view, such known devices are not always very easy to use.
The reason for this is that, traditionally, said first tubular connector is generally continued via an elongate cannula whose length can be up to several tens of centimeters, the free end of said cannula having to open out at the operating site or in the cavity concerned. Given that the surgeon's hand is situated above the patient lying on the operating table, and that said elongate cannula, of substantial length, is situated in a continuation of said oblong body, the surgeon is forced to tilt his hand backward about his wrist so that said elongate cannula assumes an inclined position which is such that its free end opens out at the desired location. This results in an uncomfortable and tiring position for the surgeon's hand.
Furthermore, the usual hold described hereinabove may not suit certain surgeons who would prefer a different hold, albeit compatible with the arrangement and flexibility of the conduits connecting the device to the source of irrigating liquid and the aspiration means.
The chief aim of the present invention is to increase the ease of use of the devices with which it is possible to perform aspiration and irrigation of body sites and body cavities.
To this end, according to the invention, the device of the type described hereinabove is distinguished by the fact that:
is curved at one of its ends, said actuating members being located on that side of said oblong body opposite the concavity of said curve; and PA2 includes, at each of its ends, two through passages connected respectively to said internal connecting lines in such a way that each of said connecting lines connects one through passage at one end of said oblong body to a through passage at the other end of said oblong body; and PA2 at least one first joining piece carrying said first tubular connector and capable of being mounted at either one of the ends of said oblong body, in such a way that said first tubular connector is connected, in common aid in a sealed manner, to the two through passages of the end on which said first joining piece is mounted; and PA2 at least one second joining piece carrying said second and third tubular connectors and capable of being mounted at either one of the ends of said oblong body, in such a way that said second and third tubular connectors are connected respectively in a sealed manner to the two through passages of the end on which said second joining piece is mounted.
Thus, by virtue of the curved shape of said oblong body and the interchangeability of said first and second joining pieces at the ends thereof, it is possible to modify the structure of the device according to the invention in order to eliminate the disadvantages of the known devices. For example, it will be readily appreciated that when said first joining piece is mounted on the curved end of said oblong body, the elongate cannula mounted on said first tubular connector naturally assumes the appropriate inclined position, without the surgeon needing to tilt his wrist backward. Moreover, the present invention increases the possible ways in which said device can be held in a surgeon's hand, so that each surgeon obtains a hold which he finds comfortable. For example, when said second joining piece is mounted on said curved end of said oblong body while said first joining piece is mounted at the other end thereof, the surgeon can hold said oblong body with said second joining piece directed upward, the fingers other than the thumb being arranged on the side of said push buttons so that he can actuate them.
The two parts of said oblong body, which are of unequal lengths and separated by said curve, can be at least approximately rectilinear.
The angle between the axes of said parts of the oblong body is preferably at least equal to 90.degree.. This angle can be adapted for the surgeon's comfort. For this purpose it is possible, for example, to manufacture oblong bodies with greater or lesser curves, with each surgeon then choosing the oblong body whose curvature angle is at least approximately equal to 120.degree..
In one advantageous embodiment, said oblong body includes, at each of its ends, a skirt surrounding the two corresponding through passages, said skirts being identical and projecting outward, and each of said first and second joining pieces also includes a skirt surrounding respectively said first and said second and third tubular connectors and being capable of engaging on one of said skirts of said oblong body.
To fit said joining pieces on said oblong body, it is then advantageous if the skirts of the latter and those of said first and second joining pieces include cooperating locking means, for example of the type with snap fitting which cannot be undone.
Moreover, said second joining piece can include respective continuations of said second and third tubular connectors, projecting relative to the corresponding skirt, said continuations being capable of being introduced respectively into the two through passages of one end of said oblong body.
The two connecting lines inside said oblong body can be made up of flexible conduits which are crushable, said selective control means in this case comprising two guillotines respectively associated with said flexible conduits and pressed by elastic means, while said actuating members are push buttons integral with said guillotines.
In a particularly advantageous embodiment, said oblong body includes two shells which are connected along a curved joining plane and two identical end components which are provided with said through passages and are held between said shells. Said shells can be fitted to one another by snap locking, adhesive bonding, or by any other appropriate means.
Moreover, said shells, said end components and said first and second joining pieces can be made of synthetic material.
A device is thus obtained which is easy to construct and inexpensive, and which can be discarded after a single use.
Thus, all the problems of sterilization after using surgical apparatus designed for repeated use are eliminated.
For each oblong body it is possible to have at least two interchangeable first joining pieces, which are provided with elongate cannulas of different diameters and/or lengths. The surgeon can then choose the one of the two first elements which suits him best for the operation being performed.